Individual
MR. GREGORY REGIS PETROSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1 SOUTH ST, RIDGWAY, PA 15853-1817
(814) 772-7848
(814) 772-7849
Mailing address
5357 GRANT RD, RIDGWAY, PA 15853-5707
(814) 776-6351
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT007531L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1012126540001
MEDICAL ASSISTANCE
PA
Enumeration date
08/19/2006
Last updated
07/08/2007
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